PEDIATRICS Vol. 47 No. 2 February 1971, pp. 472-473
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Pica—Symptom, Vestigial Instinct, or What?

R. Palmeri M.D.1

1 Office of Public Health, State Department of Health, 79 Elm Street, Hartford, Connecticut 06115

Dr. H. H. Neumann's paper on "Pica–Symptom or Vestigial Instinct?" (Pediatrics, 46:441) raised two separate questions. I subscribe to the first question and hypothesis: (1) Chewing on hard material may be a deterrent against cavities. This discovery alone may turn out to be the answer to one of the oldest health problems and a great contribution to preventive medicine.

On the second question I strongly disagree with Dr. Neumann: (2) Can pica be explained solely and/or primarily on the basis of vestigial instinct? I believe that Dr. Neumann does not distinguish deviant behavior such as pica (not necessarily a chewing activity but rather the ingestion of a variety of always unedible materials) from the healthy habit of "chewing" on hard material (with or without ingestion but I suspect more without than with).